Abstract

To the editor: Dr. Stern (1) in his thorough account of the decline in coronary heart disease mortality and its possible causes suggests that changes in life style and better medical care are partly responsible. If this were so, one would not expect to find the trend greater in nonwhites than whites, greater for stroke, notably resistant to preventive measures (2), and occurring also for all causes of death (3).

More than 20 years ago Jones (4) in a largely forgotten paper showed that childhood disease experience played a very important part in determining life expectancy. In Sweden and the